Home and Community-Based Services Spending Plan
What is the HCBS Spending Plan?
Indiana HCBS Spending Plan provides a one-time opportunity to invest $727 million in federal relief dollars into initiatives that enhance, expand, and strengthen Indiana’s home and community-based services ecosystem. Home and community based services provide opportunities for Medicaid beneficiaries to receive services in their own home or community rather than in an institution, such as a nursing facility. These programs are intended to assist a person to be as independent as possible and live in the least restrictive environment possible while maintaining safety in the home. To date, the State has deployed hundreds of millions of dollars in funding, delivering critical relief to families and stabilizing provider businesses. This work remains a key priority for FSSA, and we are grateful for the involvement and insight of our partners and stakeholders throughout the state as we continue to steward these investments.
States are in a unique position to accelerate the expansion of HCBS, which offer older adults and individuals with disabilities greater choice and control in regards to services that help them achieve greater quality of life. As Indiana makes strides to strengthen HCBS to improve Hoosier health and well-being, FSSA prioritizes transparency and stakeholder involvement.
- Direct Service Workforce Investment Grant
Overview: A critical short-term wages and benefits strategy in the form of a direct service workforce investment grant opportunity.
A key and critical focus of the Indiana Family and Social Services Administration’s Home- and Community-Based Services Spend Plan is on supporting our direct service workforce. To that end, we are putting the final touches on a Direct Service Workforce State plan that will include short-, mid-, and long-term strategies around wages and benefits; training and pathways; and promotion and planning.
In advance of the DSW State Plan release, FSSA is excited to launch a critical short-term wages and benefits strategy in the form of a direct service workforce investment grant opportunity. Direct service workers are essential in providing the day-to-day, in-person HCBS supports necessary for people to live, work, and participate in their communities. FSSA is dedicating $130 million to this opportunity with a requirement that 95% of funding awarded flow through to direct service workers.
To receive funding, interested and eligible providers must submit an attestation form at this link by December 22, 2022.
Purpose: The purpose of the grant is to help HCBS providers invest in their direct service workforce through financial compensation, retention, and wraparound benefits. The majority of funding will be required to go directly to the direct service workers to recognize the extraordinary impact of their work.
Eligibility Criteria: To be eligible for the Direct Service Workforce Investment Grant, the provider must comply with the following:
- Active during State Fiscal Year 2022: Defined as having submitted claims for qualifying paid expenditures during State Fiscal Year 2022 (July 1, 2021 - June 30, 2022)
- Currently active: Defined as currently providing services to Medicaid beneficiaries
- Medicaid Provider that provides services to individuals in the home and community: As of the date of attestation, providers must be an actively enrolled IHCP provider and delivering the following types of services:
- Adult Day Services
- Adult Foster Care
- Assisted Living
- Attendant Care (including Self-Directed Attendant Care)
- Community/Day Habilitation
- Extended Services
- Facility Based Supports
- Facility Habilitation
- Home Health Services
- Participant Assistance and Care
- Pre Vocational
- Program of All-Inclusive Care for the Elderly
- Residential Habilitation and Support (Hourly & Daily)
- Respite Care
- Structured Family Caregiving
- Waiver Transportation
- Workplace Assistance
Grant Requirements: Awardees are required to do the following, which providers must attest to as part of the attestation form:
- Direct 95% of the grant funding to direct service workers
- Develop a plan for how they will direct grant funding to direct service workers. Completed plans must be posted to the provider’s public-facing website and submitted in the attestation no later than Dec. 22, 2022.
- Respond to a final grant impact survey that captures how the dollars were spent
- Obligate money from each round prior to receiving the next round of funding
- Comply fully with the HCBS Settings Rule: After the March 17, 2023 deadline, providers must be compliant in order to receive further rounds of funding. For further detail on the settings compliance, please see the FAQ to be posted on the HCBS website or the guidelines outlined by CMS.
Methodology: FSSA intends to distribute $130 million in total funding. Payments will be a flat percentage of qualifying SFY 2022 claims expenditures for each provider. The flat percentage applied to calculate grant amounts will be established based on provider participation.
Attestation Process and Payment Timing: The grant will be distributed in three equal payments, with the first payment round targeted for January 2023 and subsequent payment rounds expected to be in the spring and summer of 2023. Providers must complete the attestation form prior to the below stated deadline to qualify. After completing this attestation, eligible providers will receive an award notice with an estimate of their funding amount per payment round. Providers will be required to confirm they are still an active Medicaid provider before each payment round. Additional providers, or providers seeking to add additional service locations to their initial application, will not be allowed to apply after the Dec. 22, 2022 deadline.
How to Apply: Interested and eligible providers must submit an attestation form at this link by Dec. 22, 2022.
Providers are required to submit one complete Attestation Form for each Medicaid Provider ID. The Medicaid Provider ID is a nine-digit number. If you provide services in multiple locations, please include the letter at the end of your nine-digit Medicaid Provider ID.
Allowable Expenses: 95% of grant funds must be directed to the direct service workforce through financial compensation, wraparound benefits, or retention.
FSSA is planning to host a webinar on Dec. 1, 2022, at 1 P.M. ET to provide an overview of the grant. For more information on the grant or the webinar, please see FAQ and look out for further communication from FSSA. Please submit any questions to email@example.com.
- Open Future Learning Opportunity
Overview: The Bureau of Disabilities Services is offering trainings for direct service personnel on supporting person-centered services and integration strategies.
- HCBS Settings Rule Grant Now Open for Eligible Providers
Overview: Grant opportunity for eligible Medicaid waiver providers in support of their ongoing efforts to comply with the federal HCBS Settings Rule.
The Indiana Family and Social Services Administration is pleased to announce that the HCBS Settings Rule Grant is now open. This grant is intended to award funds to eligible Medicaid waiver providers in support of their ongoing efforts to comply with the federal Home- and Community-Based Services Settings Rule.
- Background: In advance of the March 2023 Settings Rule compliance deadline, the Division of Aging is making the HCBS Settings Rule Grant funds available by to support the compliance efforts of eligible providers.
- Purpose: To assist with the expenses of staff time necessary to update and implement policies, as well as to address any physical modifications to a provider site.
- Eligibility: Providers currently engaged with a Settings Rule evaluator to finalize compliance or remediate issues for compliance are eligible for funds. The Division of Aging will email providers an eligibility letter and invitation to attest interest in the grant funds.
For more information, please see the eligibility letter. Please direct any questions and/or feedback to firstname.lastname@example.org.
- Type II Ambulance Grant Program Extension
Overview: FSSA identified a gap in NEMT service delivery to members residing in their own homes and requiring transportation. By increasing this specialized fleet of vehicles, FSSA is seeking to reduce the non-provider assigned rate and stabilize delivery for this sub-group of members.
FSSA has opened a second round of funding and extended the deadline to submit an application for the HCBS Type II “Sprinter” Ambulance Grant Program. Applications are now due February 1, 2023.
Additionally, FSSA has clarified if awarded a grant, providers must order vehicle(s) by no later than May 31, 2023, and provide proof of purchase. Providers must also confirm receipt of vehicle(s) and when vehicle(s) are operational to serve homebound, Medicaid waiver members.
An updated RFF is linked below along with a template of the quarterly report providers will be required to submit.
The Indiana Family and Social Services Administration is pleased to announce the Type II “Sprinter” Ambulance Grant Program, as described in our HCBS Enhanced FMAP Spend Plan, is now open to Indiana units of local government and ambulance operators actively serving the state of Indiana’s Fee for Service Medicaid members as an active participant in our Non-Emergency Transportation Network, brokered by Southeastrans, Inc.
As part of FSSA’s Home and Community-Based Services Spend Plan, OMPP is issuing grants to qualifying providers to cover the cost to purchase Type II “Sprinter” ambulances.
Purpose: The purpose of these grants is to improve transportation services to members residing in their homes and needing non-emergent care and services within their community that require the use of Type II “Sprinter” ambulances.
OMPP is making a one-time, federally funded opportunity to cover the cost to purchase a Type II “Sprinter” Ambulance at $110,000 per vehicle, and up to two vehicles per applicant, aimed at increasing Non-Emergency Medical Transportation services.
Eligibility criteria: To be eligible for an HCBS Type II “Sprinter” ambulance RFF-2022-018, providers must meet the following criteria as of the date of grant application submission:
- Appropriately licensed to operate ambulances and must be actively enrolled as a transportation provider in the state’s Medicaid fee-for-service NEMT program, currently administered by Southeastrans, Inc.
- Willing to pick up members at their own residence, i.e., home, condo or apartment. Separate funding is available to assist members in addressing structural accessibility issues that may reduce/limit the ability of EMS to enter the residence with the necessary equipment.
- Able to submit a quarterly usage report and an annual impact report to OMPP.
- Agree to schedule and bill for services according to the state and NEMT broker policies.
- Comply with the requirements of 2 CFR 200.313 – Equipment upon receipt of grant funds, and cooperate with the appropriate state or federal agencies to verify ongoing compliance.
How to apply:
- Applicants must submit a technical proposal, budget and budget narrative as outlined in the Type II “Sprinter” Ambulance Grant Program RFF-2022-018 by 4:30 p.m. Eastern Time on February 1, 2023.
- Applications must be submitted to email@example.com.
A copy of the RFF-2022-018 with attachments and more information is available below. Questions about this funding or the application process may be directed to firstname.lastname@example.org.
- HCBS Innovation Pilots: Phase 2 Application Period
Overview: The Division of Disability and Rehabilitative Services is pleased to announce funding opportunities for HCBS waiver services providers, non-provider community entities, self-advocates and families interested in exploring new means to support and address areas of outstanding need among Hoosiers.
For more information, please see the HCBS Innovation Pilot Projects application.
- 988 Crisis Supports
Overview: Indiana is using the arrival of 988 to invest in a broader crisis response system to help all Hoosiers. This will ultimately include more than just someone to contact at a 988 center, but also someone to respond and a safe place for help, if needed.
For more information, please see the 988 Crisis Support Implementation.
- HCBS Provider Readiness Grant Open for Round 2
The Indiana Family and Social Services Administration is excited to announce the HCBS Provider Readiness Grant is reopening for Round 2. FSSA is reopening this grant opportunity in order to support more providers as they prepare for the transition to a managed care system.
To apply for Round 2 of the Provider Readiness Grant, please submit the attestation at this link, before March 28, 2023. Round 2 of the Provider Readiness Grant is only available for eligible providers that were not awarded during Round 1.
Grant requirements: OMPP is awarding one-time funds at $20,000 per grant to support the implementation of a readiness project. These grant funds serve to compensate eligible providers for time away from their day-to-day agency work and include the following areas:
- Complete the 7 HCBS Provider Readiness Trainings announced by OMPP before June 30, 2023
- Develop and implement a readiness project that enhances your business model and leads to better health outcomes for the Hoosiers you serve
- Submit a brief final report confirming attendance to the seven HCBS Provider Readiness Trainings and outlining the readiness project by June 30, 2023.
Eligibility criteria: To be eligible for the HCBS Provider Readiness Grant, providers must be an IHCP approved HCBS Aged and Disabled Waiver Provider. Please note that providers that were awarded the Round 1 of Provider Readiness Grant are not eligible for Round 2.
Provider and Workforce Impact
This flyer highlights how HCBS investments are directly impacting providers and the workforce. Updated 5/30/23.
BDS Innovative Pilot Projects
BDS Innovative Pilot Projects are a way to explore new means and methods to support and address outstanding needs among Hoosiers receiving services from BDS. Updated 4/24/23
The HCBS Overview provides an overview of Phase 1 and Phase 2 of the HCBS Spend Plan. Updated 5/8/23
Direct Service Workforce Plan Overview
The DSW Plan Overview summarizes the three key areas of investment outlined in the DSW Plan. Updated 12/1/22
Build Learn Grow Impact Report - January 2024
The Build, Learn, Grow Impact Report highlights agency-wide guiding principles and outcomes to demonstrate how FSSA is leveraging federal relief funding. Updated 1/31/24
HCBS Stabilization Grant One-Pager
The HCBS Stabilization Grant Overview highlights the impact of the $176M issued to stabilize Indiana’s workforce and provider network. Updated 8/23/22
- Provider Readiness Grants
Launched in the fall of 2022, the Provider Readiness Grants provided $20,000 in financial support to 373 HCBS LTSS providers as an investment in their success in a managed care system. This grant opportunity has closed and disbursement to awarded providers is in progress.
- HME/DME Stabilization Grant
Launched in the fall of 2022, FSSA issued grants to recognize the important role that HME/DME providers play in serving vulnerable Hoosiers in the home and community. This grant opportunity has closed and disbursement to awarded providers is in progress.
- Wheelchair Van and Lift Grant Program and Bariatric Ambulance Grant Program
In the fall of 2022, FSSA issued two grant programs to help providers purchase specialized bariatric ambulances and wheelchair vans. This grant opportunity has closed and disbursement to awarded providers is in progress.
- HCBS Stabilization Grant
In the spring of 2022, FSSA distributed $176M to stabilize Indiana’s workforce and provider network and meet urgent needs in the HCBS landscape. For more information, see the HCBS Stabilization Grant Overview listed under ‘Highlights.’ This grant opportunity has closed.
- Care Coordination for Children with Medical Complexity
The state awarded a grant to the Medicaid-funded Children with Medical Complexity Care Cooperation Pilot Project. Funding supported nurse care coordinators and the centralized resource and training center at the IU Academic Health Center.
- Direct Service Workforce Investment Grants
In January 2023, FSSA issued the first round of Direct Service Workforce Investment Grants to 826 home and community-based services Medicaid providers that met the grant eligibility criteria. FSSA dedicated approximately $130 million to this opportunity and the awarded providers are required to pass at least 95% of the grant funding directly through to their direct service workers. The Direct Service Workforce Investment Grant opportunity includes a total of three equal payments and FSSA will issue the subsequent payment rounds in March and June of 2023. For more information on the grant, please click here.
Helpful Resources to Learn More
- HCBS Spend Plan Resources
- Indiana’s HCBS spend plan
- Indiana’s HCBS Spend Plan outlines in full detail how FSSA plans to invest the $727 million from Section 9817 American Rescue Plan Act of 2021.
- CMS Conditional Approval
- Quarterly Report to CMS 10/18/21
- Quarterly Report to CMS 1/31/22
- Quarterly Report to CMS 4/18//22
- Quarterly Report to CMS 7/15//22
- Quarterly Report to CMS 10/17//22
- Quarterly Report to CMS 1/13/23
- Quarterly Report to CMS 4/14/2023
- Quarterly Report to CMS 7/17/23
- Quarterly Report to CMS 1/17/24
- Indiana’s HCBS Spend Plan outlines in full detail how FSSA plans to invest the $727 million from Section 9817 American Rescue Plan Act of 2021.
- Direct Service Workforce Plan
- In November 2022, FSSA released the Indiana Direct Service Workforce Plan focused on three key areas: 1) wages and benefits, 2) training and pathways, and 3) promotion and planning.
- Section 9817 of the American Rescue Plan Act
- This guidance issued by CMS outlines how States can use the HCBS funding.
- Indiana’s HCBS spend plan
- Other FSSA HCBS Resources
- Build Learn Grow Program Impact Reports
Any questions or comments?
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